Evidence map›Paper›PMID 33677526›Full record

SynthesisCardiovascular research2022

Prevalence of microvascular angina among patients with stable symptoms in the absence of obstructive coronary artery disease: a systematic review.

Elif Aribas, Jeanine E Roeters van Lennep, Suzette E Elias-Smale, Jan J Piek, Maurits Roos, Fariba Ahmadizar, Banafsheh Arshi, Dirk J Duncker, Yolande Appelman, Maryam Kavousi

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in Cardiovascular research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  4. Trial
  5. Article
  6. Article
  7. Invasive Endotyping of Angina Pectoris with Nonobstructive Coronary Arteries.The International journal of angiology : official publication of the International College of Angiology, Inc · 2025
    Review
  8. Coronary microvascular dysfunction in systemic inflammatory diseases: From pathophysiology and prevalence to diagnosis and management.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2025
    Review
  9. Article
  10. Societal, occupational, and economic considerations for women with (M)INOCA: a narrative review.International journal of occupational medicine and environmental health · 2025
    Review
  11. Review
  12. Article
  13. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Elif AribasDepartment of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Office Na-2714, PO. Box 2040, 3000 CA Rotterdam, The Netherlands.ORCID 0000-0003-2736-7542
Jeanine E Roeters van LennepDepartment of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Suzette E Elias-SmaleDepartment of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Jan J PiekDepartment of Cardiology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands.
Maurits RoosDepartment of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Office Na-2714, PO. Box 2040, 3000 CA Rotterdam, The Netherlands.
Fariba AhmadizarDepartment of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Office Na-2714, PO. Box 2040, 3000 CA Rotterdam, The Netherlands.ORCID 0000-0002-6261-9445
Banafsheh ArshiDepartment of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Office Na-2714, PO. Box 2040, 3000 CA Rotterdam, The Netherlands.
Dirk J DunckerDepartment of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.ORCID 0000-0003-2836-2241
Yolande AppelmanDepartment of Cardiology, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands.
Maryam KavousiDepartment of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Office Na-2714, PO. Box 2040, 3000 CA Rotterdam, The Netherlands.
Erasmus MC · NLAmsterdam University Medical Centers · NLRadboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Our purpose was to perform a systematic review to assess the prevalence of microvascular angina (MVA) among patients with stable symptoms in the absence of obstructive coronary artery disease (CAD). We performed a systematic review of the literature to group the prevalence of MVA, based on diagnostic pathways and modalities. We defined MVA using three definitions: (i) suspected MVA using non-invasive ischaemia tests; proportion of patients with non-obstructive CAD among patients with symptoms and a positive non-invasive ischaemia test result, (ii) suspected MVA using specific modalities for MVA; proportion of patients with evidence of impaired microvascular function among patients with symptoms and non-obstructive CAD, and (iii) definitive MVA; proportion of patients with positive ischaemia test results among patients with an objectified impaired microvascular dysfunction. We further examined the ratio of women-to-men for the different groups. Of the 4547 abstracts, 20 studies reported data on MVA prevalence. The median prevalence was 43% for suspected MVA using non-invasive ischaemia test, 28% for suspected MVA using specific modalities for MVA, and 30% for definitive MVA. Overall, more women were included in the studies reporting sex-specific data. The women-to-men ratio for included participants was 1.29. However, the average women-to-men ratio for the MVA cases was 2.50. In patients with stable symptoms of ischaemia in the absence of CAD, the prevalences of suspected and definitive MVA are substantial. The results of this study should warrant cardiologists to support, promote and facilitate the comprehensive evaluation of the coronary microcirculation for all patients with symptoms and non-obstructive CAD.

Indexed as

Coronary Artery DiseaseMicrovascular AnginaCoronary CirculationFemaleHumansMaleMicrocirculationPrevalenceCoronary microvascular dysfunctionMicrovascular anginaNon-obstructive coronary artery diseasePrevalenceSystematic review

Identifiers

PMID33677526
PMCPMC8859625
OpenAlexW3133970813

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.